Recent reports made crude calculations for the cost of RIO, by dividing the
cumulative weight loss by the number of patients referred.

To accurately assess the cost-effectiveness of RIO we need to look at those
patients who have completed their 6m weight loss programme. Furthermore, this
calculation should not include children, when in the majority of cases (for good clinical reasons) we aim for
weight maintenance rather than loss.

In addition we should take into account the
huge financial savingsthat have already been demonstrated from this
specialist approach to weight management. The
anticipated number of adults expected to need costly bariatric surgery for weight loss during the 2010/11 year was 67, but thanks to many of these patients
being successfully managed by the RIOmulti disciplinary team
approach, this
number was slashed to just 33. The cost of
savings to the NHS just from having reduced the number of patients needing expensive and invasive surgery by
34 far exceeds the overall
annual cost of the adult specialist obesity service. We have also reduced the number of inappropriate referrals
from approximately 50% to none at all, thereby making further savings to the NHS through less wasted time for
the surgical teams.

Although harder to quantify, further savings
can be demonstrated in the management of morbidly obese children, who may otherwise require a referral to a
residential weight management camp, or future surgery.

Taking all savings into
account we are already be

savingthe tax-payer
money.

The Foresight Report published in 2007 showed that the direct (cost of prescriptions,
hospital admissions and treatment of associated medical conditions caused, or worsened, by obesity etc) and
indirect (benefit costs, lost productivity, and cost to the overall economy etc) costs will escalate if
nothing is done about the obesity epidemic, and estimates suggested that it may reach a staggering£49.9 billion per year by2050.

Two thirds of the UK population are currently overweight or obese and there is
overwhelming evidence that weight loss, or even weight maintenance in patients who were otherwise increasing in
weight has significant health benefits to the individual, together with long-term savings to the NHS as a
consequence of having to treat less associated medical problems, such as type 2 diabetes and cardiovascular
disease. Morbidity and mortality are directly linked to weight, so any weight loss in an
overweight or obese individual is beneficial.